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Excerpts

Chapter 1

What Is Trauma?

Trauma, to paraphrase Webster's New Collegiate Dictionary, is an emotional shock that creates substantial, lasting damage to an individual's psychological development. As used in this book, "trauma" also refers to overwhelming, uncontrollable experiences that psychologically impact victims by creating in them feelings of helplessness, vulnerability, loss of safety, and loss of control. Although other emotional reactions may be seen (or may exist and not be seen), these are the states most likely to be present and to be uncovered by a clinician. The child victim may exhibit severe psychiatric symptoms or may superficially appear symptom-free.

The impact of an event in a child's life cannot be assessed in isolation.

An event traumatic to one youngster may be just a bad experience to another, or it may be traumatizing at one stage in life and not traumatizing earlier or later. The experience may, in fact, be a challenge to some children, who are strengthened by having met the challenge and coped with their situations. The child's constitution, temperament, strengths, sensitivities, developmental phase, attachments, insight, abilities; the reactions of his loved ones; and the support and resources available to him, all contribute to how an event is experienced, what it means to the child, and whether or not it is traumatizing at that specific time in the child's life.

The traumatizing event may be a single occurrence such as witnessing violence or an injury to self, or a series of interactions which, in totality, is traumatic. Examples might include incest, a long exposure to deprivation, a prolonged custody battle, surviving an airplane crash, or seeing people killed during war. The trauma may be directly physical, such as involvement in an accident, or solely psychological, as may occur when a child witnesses a disaster in which people are killed or injured, or when a parent whispers erotic longings to him.

Children have always been traumatized. It is only recently, however, that researchers and clinicians have begun to pay special attention to the effects of trauma on children -- attention that is probably an outgrowth of social, political, and technological changes. Reporting systems and communication improvements have brought about an awareness of the widespread sexual abuse of children. Post-traumatic stress disorder has been identified in Viet Nam war veterans. The women's movement has brought us to a greater awareness of the problems of rape and incest. Trauma is not new, but how we recognize and deal with it is new.

Research suggests that the impact of trauma on a child may have lifelong psychobiological consequences, depending on the developmental stage of the child at the time of trauma, his coping abilities, and the meaning of the event to the child. As research continues and theories are developed and refined, we should expect new implications for treatment that will assist the clinician in working with these children.

Copyright © 1989 by The Free Press